Organization
MOBILE NP-ADULT HEALTH OF CNY, P.C.
Active
Other names
MobileMed
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DESTA ANTHONY (PRESIDENT)
(315) 437-1693
Entity
Organization
Contact information
Practice address
124 RUGBY RD, SYRACUSE, NY 13206-3225
(315) 437-1693
Mailing address
124 RUGBY RD, SYRACUSE, NY 13206-3225
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
303332
NY
Other
Enumeration date
07/26/2007
Last updated
07/26/2007
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